Hepatitis-C virus, not HIV, bigger epidemic in northeast

GUWAHATI: With little awareness about increasing Hepatitis-C cases in the northeast, activists and medical practitioners warned that unless effective programmes were implemented, there would be a further escalation in the number of people falling prey to the dreaded virus.

Often referred to as a viral time bomb, the disease is widespread among intravenous drug users (IDUs). Manipur’s Surachanpur and Bishnupur districts have the highest number of people carrying the Hepatitis-C virus (HCV), with prevalence rates among the districts’ IDUs being nearly 90 per cent and 78 per cent respectively.

In Nagaland’s Wokha and Phek districts, the prevalence rate, as per an Integrated Bio Behavioural Assessment Round 2 Testing, conducted in 2009 by the Indian Council of Medical Research and others, was 20.8 per cent and 8.7 per cent respectively. Prior studies showed that in Manipur, the prevalence rate of HCV is 55 to 80 per cent among IDUs, as opposed to 22 to 33 per cent HIV prevalence among them.

“The main objective is to create awareness about viral Hepatitis in the region. The epidemic is at our doorstep, with people getting infected, testing positive and some deaths being reported. However, NGOs and the government continue to ignore the spread of the disease,” said Ketho, general secretary of Hepatitis Coalition of Nagaland (HEPCON).

With much of the focus being restricted to HIV-AIDS and cancer awareness, HCV often escapes attention. With no proper cure or vaccine, course-related HCV treatment is also considered too expensive. People with HCV are prone to develop chronicity that can lead to liver damages. Research show that close to 75 to 85 per cent HCV patients develop chronicity, as opposed to Hepatitis-B patients (HBV).

“Intravenous drug users are the most vulnerable. HCV prevalence is much higher than that of HIV. This indicates that there is a bigger pool of HCV patients among IDUs,” said Gajendra Kumar Medhi, doctor and scientist with the Indian Council of Medical Research.

Another factor responsible for the high prevalence of HCV amongst IDUs is needle-sharing. Even with efforts to promote safe injecting practices, the prevalence of needle-sharing is quite high. Users may lessen sharing of syringes, but indirect sharing is widely practiced. Nearly 50 to 70 per cent IDUs admitted to sharing accessories like common containers for drug preparation, filter cotton and rinse water.

The article appeared in The Times of India on March 11th, 2014.

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